Main findigs
Age-standardized mortality rates (ASMRs) and mortality rate ratios (MRRs) in individuals with and without a one-year history of mental health treatments
Mortality rate ratio (95% CI) | |||||||
Deaths, n (%) | Person-years (%) | ASMR (95% CI)a | Model 1b | Model 2c | Model 3d | Model 4e | |
Men | |||||||
Model accounting for primary and secondary care | |||||||
No treatments | 154 350 (87.0) | 12 917 461 (94.9) | 14.0 (13.9-14.0) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
Primary and secondary care combined | 23 124 (13.0) | 691 572 (5.1) | 37.7 (37.2-38.2) | 2.83 (2.79-2.87) | 2.17 (2.13-2.20) | 2.00 (1.97-2.03) | 1.63 (1.60-1.65) |
Primary care | 14 473 (8.2) | 394 116 (2.9) | 32.9 (32.3-33.4) | 2.26 (2.22-2.31) | 1.87 (1.84-1.91) | 1.60 (1.57-1.63) | 1.39 (1.37-1.42) |
Secondary care | 8 651 (4.9) | 297 456 (2.2) | 51.5 (50.2-52.9) | 4.78 (4.67-4.89) | 3.01 (2.93-3.08) | 3.36 (3.28-3.44) | 2.32 (2.27-2.38) |
Model accounting for secondary care onlyf | |||||||
No treatments | 168 823 (95.1) | 13 311 577 (97.8) | 14.6 (14.5-14.6) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
Secondary care | 8 651 (4.9) | 297 456 (2.2) | 51.5 (50.2-52.9) | 4.58 (4.47-4.68) | 2.83 (2.76-2.90) | 3.25 (3.18-3.33) | 2.24 (2.19-2.30) |
Women | |||||||
Model accounting for primary and secondary care | |||||||
No treatments | 158 405 (88.2) | 13 436 464 (93.0) | 9.0 (8.9-9.0) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
Primary and secondary care combined | 21 240 (11.8) | 1 004 415 (7.0) | 18.5 (18.2-18.8) | 1.79 (1.76-1.82) | 1.71 (1.68-1.74) | 1.24 (1.22-1.26) | 1.20 (1.18-1.22) |
Primary care | 13 659 (7.6) | 582 123 (4.0) | 14.3 (14.0-14.6) | 1.40 (1.38-1.43) | 1.42 (1.39-1.44) | 0.97 (0.95-0.99) | 0.98 (0.96-1.00) |
Secondary care | 7 581 (4.2) | 422 292 (2.9) | 26.7 (26.1-27.4) | 3.51 (3.42-3.60) | 2.79 (2.72-2.87) | 2.50 (2.43-2.56) | 2.06 (2.01-2.12) |
Model accounting for secondary care onlyf | |||||||
No treatments | 172 064 (95.8) | 14 018 587 (97.1) | 9.2 (9.1-9.2) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
Secondary care | 7 581 (4.2) | 422 292 (2.9) | 26.7 (26.1-27.4) | 3.44 (3.35-3.52) | 2.72 (2.65-2.79) | 2.51 (2.44-2.57) | 2.07 (2.01-2.12) |
aAge-standardized mortality rate per 1 000 person-years. Standardized to the 2013 European Standard Population by 5-year age groups. bModel 1: adjusted for Model 1: adjusted for calendar year and age group (5-year intervals). cModel 2: adjusted for Model 2: adjusted for calendar year, age group, urbanicity, region, education, living alone, household income, and economic activity. dModel 3: adjusted for Model 3: adjusted for calendar year, age group, and Charlson comorbidity index (CCI). eMortality in individuals with secondary care treatments compared to individuals without secondary care treatments (primary care ignored).
Figure 1. Mortality rate ratios in individuals with a one-year history of mental health treatments compared to individuals without such a history, stratified by mental disorder
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